All Posts Tagged: ptsd

Post-Traumatic Growth

Emotional trauma or psychological trauma is a reaction to an experience or event that is deeply distressing or disturbing to the individual. Trauma can be the result of things such as going through a natural disaster, being involved in a car accident, living through a major event, such as war or abuse, or having been the victim of a crime. A trauma response will be similar no matter what caused it.

When people experience a psychological trauma, it often shakes them to their core, especially if they felt they had little to no control over the event. They are left feeling helpless and they may experience flashbacks or have a persistent fear that something bad will happen to them again.

Even though these emotional responses are part of a normal reaction, trauma changes patterns in your brain, causing you to carry the burden of distress long after the events have passed. However, by working with a mental health professional who specializes in trauma, you can experience trauma recovery and learn to feel safe again.

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What is Trauma

In general, trauma can be defined as a psychological, emotional response to an event or an experience that is deeply distressing or disturbing. When loosely applied, this trauma definition can refer to something upsetting, such as being involved in an accident, having an illness or injury, losing a loved one, or going through a divorce. However, it can also encompass the far extreme and include experiences that are severely damaging, such as rape or torture.

Because events are viewed subjectively, this broad trauma definition is more of a guideline. Everyone processes a traumatic event differently because we all face them through the lens of prior experiences in our lives. For example: one person might be upset and fearful after going through a hurricane, but someone else might have lost family and barely escaped from a flooded home during Hurricane Katrina. In this case, a minor Category One hurricane may bring up traumatic flashbacks of their terrifying experience.

Because trauma reactions fall across a wide spectrum, psychologists have developed categories as a way to differentiate between types of trauma. Among them are complex trauma, post-traumatic stress disorder (PTSD), and developmental trauma disorder.

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Complex Trauma Disorder

Trauma can come in many forms. The soldier returning from active duty in a war zone, the child who lives with physical, sexual, or emotional abuse or neglect, the first responder who must deal with human suffering on a daily basis, and the adult who endures domestic abuse all are experiencing trauma. Complex trauma occurs repeatedly and often involves direct harm to the victim. Its effects are cumulative and generally transpire in a specific setting and, frequently, within a particular time frame or within a specific relationship.

Going through trauma can make an individual experience intense feelings of guilt, as if they are somehow responsible for the event(s) that are so terrifying to them. This altered sense of shame and painful self-perception is crippling. It can make the person feel isolated and hopeless, and as if they are no longer in charge of themselves.

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Using Virtual Reality Therapy for Phobias

 

What would you think if you had a phobia about something (example: a fear of flying) and you could overcome your fear just by sitting in your therapist’s office and watching a movie? We think you’d sign up for that! Okay, it’s not entirely that simple (although it almost is), but virtual reality therapy for phobias is now giving patients a high-tech, cutting-edge solution for helping them get past their fears so they can live a better life.

How Does Virtual Reality Exposure Therapy Work?

Many types of phobias can be overcome or greatly reduced when the sufferer goes through cognitive behavioral therapy. In this type of therapy, a patient learns to recognize the thoughts causing the negative feelings surrounding their fears. Once these thoughts are identified, the patient learns how to replace those undesirable beliefs with more positive ones.

In-vivo exposure therapy goes hand in hand with cognitive behavioral therapy. With in-vivo exposure, the patient experiences what they fear in a controlled way and in small doses. By taking small steps, they can confront and gradually conquer their phobia.

Virtual reality exposure therapy combines the best of cognitive behavior therapy and in-vivo exposure. It allows people to work through their fears in a realistic environment without actually leaving the comfort and safety of their therapist’s office.

Virtual Reality Therapy

In the case of the fear of flying phobia mentioned above, a patient comes to our office, sits in a comfortable chair, and puts on a pair of virtual reality therapy goggles. In conjunction with coaching from their therapist, they view a simulation of the inside of an airplane’s passenger compartment and can look around to see all aspects of the interior.

The patient not only sees the plane, they also hear the same sounds they would experience if they were really on a flight, such as the flight attendant’s announcement or the rumble of airplane engines. Additionally, our virtual reality therapy chair vibrates with the motion of the plane “taking off” or “flying” to provide an even more convincing simulation.

Even if a person knows the virtual reality program isn’t completely realistic, there is enough realism in it to trigger their emotional responses to their phobia. And, by working through these reactions, in some types of phobias or traumas, nearly 83 percent of people who have tried virtual reality therapy have managed to put their fears behind them.

Virtual Reality Therapy Benefits

Some of the benefits of virtual reality therapy include:

  • Allowing the patient to try the therapy without as much anxiety. For example: in the case of a phobia about flying, it is much easier for someone to agree to try working through their fears in an office than to have to force themselves to physically go to the place they know will bring an emotional reaction.
  • Experiencing the phobia and/or its triggers without taking the time to travel to an actual location. For the fear of flying phobia, you simply sit in a chair, rather than going to the airport numerous times for several small exposures to your triggers.
  • Confidentiality for the patient: you don’t have to face potential embarrassment by running into someone you know or possibly becoming upset in a public area.
  • The therapist can carefully control the situation, meaning if you are afraid of elevators or airplanes, you don’t have to get in one. Virtual reality exposure therapy allows you to feel as if you are in a location, but the therapist can stop the program if you become truly upset.
  • The therapy is more realistic, in that you can go places or experience things you wouldn’t ordinarily be able to (you can’t get on and off an airplane as part of your flying phobia therapy, for instance). That being said, it is much safer than the real-life setting and minimizes any risk involved.
  • Virtual reality exposure therapy sessions are shorter than those that require you to visit an actual site for therapy (so, there is no travel time from the therapist’s office to the airport for our fear of flying scenario.)
  • Sessions can be repeated several times until the patient has conquered that portion of their phobia and is ready to move on to another phase.

Studies show this treatment has a powerful real-life impact and a great track record, over time. Virtual reality therapy has been successful in treating both children and adults for PTSD (post-traumatic stress disorder), social anxiety, panic disorder, anxiety disorder, OCD (obsessive compulsive disorder), and phobias. It is also a very effective tool for treating children who suffer from phobias such as school phobia or sleep fears.

Do You Have Questions About Virtual Reality Therapy?

Virtual Reality Therapy is coming to our practice very soon. For more information or to find out when it becomes available, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us today at 561-496-1094.

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Children’s Mental Health – Psychiatric Help for Children

While we tend to think of childhood as a carefree time of life, the fact is that many children suffer from mental conditions and disorders, just the same as adults. Among other things, children’s mental health concerns can include emotional, behavioral, and mental disorders such as eating disorders, learning and developmental disabilities, Attention Deficit Hyperactive Disorder (ADHA), and autism. And, similar to adults, children can be impacted by conditions like anxiety, depression, Obsessive Compulsive Disorder (OCD) and Post-traumatic Stress Disorder (PTSD). Additionally, as children grow and mature into young adults, they can develop other problems associated with adolescence, such as underage drinking and substance abuse.

Left untreated, any of these conditions or disorders can result in difficulties with making friends, and behavior issues in school and at home. What is most troubling, however, is that research has shown that a majority of adult mental disorders start early in life. This makes it critical that children’s mental health conditions be caught promptly and treated appropriately.

Symptoms of Child Psychological Disorders

Child psychological disorders and conditions can affect any ethnic group, and income level, and those living in any region of the country. In fact, the Centers for Disease Control (CDC) cites a study from a National Research Council and Institute for Medicine report that estimates about 1 in 5 children across the United States will experience a mental disorder in any given year.

Symptoms often change as a child grows and matures, so the signs of a problem may be difficult to spot in the early stages. Often, parents are the first to recognize that there is an issue with their children’s emotions or behavior, however problems may also be brought to your attention by your child’s educators or another adult who knows your child well. Some general signs to look for include:

  • Marked decline in school performance
  • Strong worries or anxiety that causes problems at home or at school
  • Random, frequent physical aches and pains, such as headaches or an upset stomach
  • Difficulty sleeping, nightmares
  • Marked changes in eating habits
  • Feeling hopeless
  • Having low or no energy
  • Aggressive behavior, disobedience, and/or confrontations with or defiance of authority figures
  • Temper tantrums or outbursts of anger
  • Thoughts of suicide or thoughts of harming themselves or others

Psychiatric Help for Children

  • Please get immediate assistance if you think your child may be in danger of harming themselves or someone else.  Call a crisis line or the National Suicide Prevention Line at 1.800.273.TALK (8255).

Getting psychiatric help for children, in the form of early diagnosis and receiving the correct treatment, is essential for your child’s well being, both now and throughout their life.

If your child’s problems persist across a variety of settings (for example: home, school, and with peers), some of the steps to get help include:

  • Talk to your child about how they are feeling. Find out if they would like to discuss a problem with you or another adult. Actively listen to their responses and concerns.
  • Talk to your child’s pediatrician, school counselor or school nurse, or a mental health professional if you see behaviors or problems in your child or teen that worry you.
  • Seek evaluation from a specialist who deals with children’s mental health concerns.
  • Ask the specialist if they have experience with treating the problem or behavior you see in your child.
  • Don’t delay in seeking help – early treatment generally gives better results.

Children can be treated in a variety of settings that range from one-on-one (or with a parent) sessions with a mental health professional to a group setting with a therapist and the child’s peers. Talk therapy can help change behaviors and may be used in combination with other treatments. Cognitive Behavioral Therapy (CBT) has been shown to be very effective in helping children learn coping strategies so they can change unhealthy behavior patterns and distorted thinking. Additionally, medications may be recommended for disorders such as ADHD or may be given for other types of severe or difficult cases.

Need More Information on Children’s Mental Health?

If you have questions or need more information about psychiatric help for children, we can help. The professionals at our child-focused department, The Children’s Center, specialize in child psychiatry and psychology, and other services related to children’s mental health. For more information, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us today at 561-496-1094.

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Media-Related Post Traumatic Stress Disorder

Veterans of the Vietnam war have sadly raised our awareness of the existence of Post Traumatic Stress Disorder (PTSD). PTSD is a chronic, sometimes lifelong condition resulting in pathological changes in mood, thinking and behavior. It can be incapacitating and lead to job loss, family turmoil and dissolution, poor quality of life and often suicide.

We now understand that the development of Post Traumatic Stress Disorder has its basis in enduring alterations of brain function, which helps to explain the chronic, persistent nature of this disorder. Treatment can be helpful but frustratingly inadequate. Unfortunately, there is no “magic bullet” medication. Research has supported the use of specific psychotherapeutic protocols but community availability can be a problem.

While PTSD’s origins stemmed from war related trauma, we now understand that a wide spectrum of life stressors can result in this disorder. The twenty-first century has brought terror attacks to the world stage. “Lone wolf” attacks, Islamic terrorism, and most recently, violence against the police have become a national preoccupation. In previous decades, our awareness of Post Traumatic Stress Disorder was based on either our familiarity with individuals suffering from this disorder or the occasional print news article. However, the media technology revolution of our current century has brought us both the blessing and curse of 24/7 connectivity to world and national events.

Post Traumatic Stress Disorder  and Media Coverage of Traumatic Events

For several years, the therapists at the Center for Treatment of Anxiety and Mood Disorders have been very concerned about the repetitive exposure to traumatic life events that people experience via internet and television broadcasts. Recent terror attacks around the world are cases in point, for one cannot avoid the media’s persistent replaying of the visual imagery and dramatic accounts of these human tragedies.

Before the media revolution we learned of traumatic events through the newspaper, the 6:00 pm news, or the news hour on the radio. One only has to recall the steady calm recitation of bad news by the likes of Walter Cronkite and compare it to the present day dramatic and horrifying presentation of similar news stories. Clearly, horror sells and is profitable. We have become captive audiences for this traumatic exposure. To make matters worse, we are transfixed by it and have difficulty “unplugging” ourselves from the TV set or internet.

This brings our therapists to their greatest clinical concern. Repetitive exposure to graphic trauma has an impact on our central nervous systems. Even though we may not be the victim of the terror, we are passively being terrorized. Adults have a greater capacity to process such horror, but imagine the difficulties this creates for our children. Their immature nervous systems and reasoning ability pose significant obstacles for coping with this type of daily non-stop life stress. We fear that we are all becoming victims, in our own way, of the “madness” we are being exposed to.

We have a responsibility to control our children’s exposure to traumatic media and to prevent the damage that can result. As adults, we should heed this advice, as well. Ultimately, we must change the way that public media communicates traumatic events, however, this is easier said than done.

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Complex PTSD

 

The majority of us have heard about PTSD (Post-Traumatic Stress Disorder), the condition that can occur when someone is exposed to a situation over which they had little or no control and from which there was little or no hope of escape. It is often associated with members of the military who have witnessed the horrors of battle, or with people who have endured an extreme physical or emotional trauma. PTSD can occur after experiencing even just one threatening situation, such as being involved in a car accident. But, what about those who have gone through long-term exposure to a continuing, intense level of stress?

Recently, mental health experts have begun to realize there are more layers to the emotional suffering experienced by people who have been through long-lasting stressors like childhood sexual abuse, for example, or years of domestic violence. In cases like these, a PTSD diagnosis partly addresses their condition, but doesn’t adequately define the severe psychological harm that has resulted from the trauma. Therefore, some mental health professionals now believe there should be a new category added to the PTSD diagnosis – one that will encompass this emotional scarring from long-term, chronic trauma: Complex PTSD (C-PTSD).

Even with this new classification, it is important to note that the victims of chronic trauma can have both PTSD and Complex PTSD simultaneously. Here is an easy way to see the differences between the two conditions:

  • A child witnessing the death of a friend in an accident may show some symptoms of PTSD
  • A child who has lived with years of sexual or physical abuse may have symptoms of C-PTSD in addition to PTSD.

CPTSD Symptoms

People who have gone through a long-standing, extremely traumatic situation may exhibit both physical and emotional symptoms related to their ordeal.

Emotional symptoms may include:

  • Rage displayed through violence, destruction of property, or theft
  • Depression, denial, fear of abandonment, thoughts of suicide, anger issues
  • Low self-esteem, panic attacks, self-loathing
  • Perfectionism, blaming others instead of dealing with a situation, selective memory
  • Loss of faith in humanity, distrust, isolation, inability to form close personal relationships
  • Shame, guilt, focusing on wanting revenge
  • Flashbacks, memory repression, dissociation

Victims of C-PTSD may also have physical symptoms, such as:

  • Eating disorders, substance abuse, alcoholism, promiscuity
  • Chronic pain
  • Cardiovascular problems
  • Gastrointestinal problems.
  • Migraines

Help for Complex PTSD

With Complex PTSD, healing cannot happen on its own because the survivor keeps reliving the trauma through flashbacks and dreams. People who suffer from C-PTSD may go for years before making the connection between their symptoms and the chronic stress and trauma they have been trying to cope with. Once they do, healing can begin and many people have been able to overcome their past to find a more meaningful and healthy present.

Cognitive Behavioral Therapy (CBT) has been shown to be highly effective in treating both PTSD and Complex PTSD. This therapy works to change unhelpful thinking and behaviors. It challenges deep-seated patterns and beliefs. CBT therapy helps replace “errors in thinking” (for example: magnifying negatives, minimizing positives, and overthinking) with more realistic and effective thoughts. This serves to decrease both emotional distress and self-defeating behaviors.

EMDR (Eye Movement Desensitization and Reprocessing) is a fairly new therapy that helps specifically in the treatment of trauma recovery and Post Traumatic Stress Disorder/CPTSD. It has been shown to help trauma survivors heal faster than through traditional therapy. In fact, EMDR can be successful in as few as 3-12 treatment sessions. This means that relief from your pain is not only possible but it can be obtained in a relatively short amount of time.

We Can Help

Complex PTSD can be debilitating. Those who suffer from CPTSD may be at greater risk of substance abuse or of deliberate self-harm in order to cope with their emotional pain. We can help! To learn more, contact the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email The Center today.

 

 

 

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EMDR Therapy Helps Trauma Recovery

Eye Movement Desensitization and Reprocessing (EMDR) is a fairly new therapy that helps specifically in the treatment of trauma recovery and Post Traumatic Stress Disorder (PTSD). PTSD is a disorder that often develops after exposure to a terrifying event or ordeal – one in which intense physical harm occurred or was threatened. PTSD can also result after someone has witnessed an event that is disturbing, distressing, or dangerous. Sufferers of this disorder have persistent, frightening thoughts and memories of their ordeal.

PTSD can be triggered by events such as:

  • Military combat
  • Violent personal assaults
  • Natural or human-caused disasters
  • Car accidents, plane crashes

To understand EMDR therapy, it’s important to first understand how PTSD can impact people. People who have developed this type of disorder often have ‘re-experiencing symptoms’ or exhibit avoidance symptoms, which can include:

  • Flashbacks of the event
  • Nightmares and bad dreams
  • Uncontrollable and frightening thoughts about the event
  • Avoidance of people, activities, or places that remind them of the traumatic experience
  • Severe emotional distress or physical reactions to something that makes them think of the event
  • Irritability, aggressive behavior, angry outbursts
  • Feeling guilt, shame, or worry about the event

What is EMDR?

A great way to understand EMDR is to think through the body’s normal healing process. When you cut yourself, your body works on its own to heal the injury. If the wound is irritated by a foreign object, the abrasion festers and the body is unable to close the wound until the object is removed.

There is evidence to support the theory that the mind works in much the same way. With post traumatic stress disorder, healing cannot happen because the survivor keeps reliving the trauma through their flashbacks and dreams. Those memories are the “foreign objects” that fight the healing process.

Effective EMDR therapy includes some important elements:

  • Processing of the traumatic memory and disturbing feelings
  • Transformation of the painful events on an emotional level
  • Empowerment of the person dealing with PTSD

EMDR therapy also involves using bilateral (both sides of the body) stimulation, such as:

  • Eye movements
  • Physical hand tapping or toe tapping
  • Musical tones

These bilateral stimuli and the guidance of the therapist allow the survivor to tap into the biological mechanisms that come into play during Rapid Eye Movement (REM) sleep. It is believed that this allows the individual to naturally process their memories – effectively removing those “foreign objects” so their mind can heal.

What Does EMDR Therapy Include?

Eye movement desensitization and reprocessing therapy consists of eight therapy phases that are focused around three specific time periods:

  • The past – the event(s) that created or intensified the trauma is identified
  • The present – attention is given to the current situations that are causing distress
  • The future – action is taken to develop the skills and attitudes needed for positive progress

Phase 1: The therapist works with the individual to uncover the incident or trigger event from the survivor’s past that might be relevant for the therapy. This may include not only the traumatic event, but also other incidents from the person’s past. The treatment plan is developed during this stage.

Phase 2: The therapist teaches the individual a variety of stress reduction and imagery techniques that can be used during and between sessions to help them handle their emotional distress.

Phases 3-6: A target memory is chosen and processed using EMDR therapy techniques. In order to start this procedure, the individual must identify the following:

  1. Emotions and physical sensations related to the memory
  2. Visual imagery related to the memory
  3. A negative belief about themselves that is related to their distress
  4. A positive belief they’d like to have

The therapist asks the individual to rate the strength of the negative and positive beliefs they choose. Then, the person is instructed to focus on the imagery, negative thoughts, and body sensations they relate to the target memory while the therapist directs them in performing the bilateral stimulation that is the hallmark of EMDR therapy. These steps are done repetitively in ‘sets’, with the survivor rating the strength of the negative beliefs after each set. Once the person no longer reports distress related to the memory, the therapist will repeat the process while focusing on the positive belief previously identified.

Phase 7: This is the closure phase, where the trauma survivor keeps a log of any lingering negative thoughts or emotions that come up throughout the week. By reviewing the person’s journal of their negative emotions or thoughts, the therapist gains information to help the individual continue to work through their pain while reminding them of self-calming techniques learned during therapy.

Phase 8: In this final phase, the therapist and patient examine the progress made during previous sessions.

How to Get Help

One of the benefits of EMDR is that it has been shown to help trauma survivors with post traumatic stress disorder heal faster than through traditional therapy. Look at these amazing results:

  • One study revealed 84%-90% of single-trauma victims no longer had PTSD after only three 90-minute sessions
  • Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims were no longer diagnosed with PTSD after six 50-minute sessions
  • A third study showed that 77% of combat veterans were free of PTSD in 12 sessions

This means that relief from your pain is not only possible but it can be obtained in a relatively short amount of time. If you or someone you know is suffering from PTSD, seeking professional help can be the most direct path to reclaiming your life.

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For more information about EMDR and how EMDR therapy can help you or a loved one overcome trauma and PTSD, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us at 561-496-1094.

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PTSD Symptoms Rise After Hurricane Sandy – Even in South Florida

In the aftermath of Hurricane Sandy, the Northeast is struggling to return to normal. As of November 1, 2012, it was reported that nearly 650,000 people were still without power, looters were ravaging the streets, the U.N. Headquarters in New York was severely damaged, and the subway systems had been shut down, among other things.

Fortunately, most damage will be repaired. It may take time, but eventually all power will be restored, the U.N. building will be repaired, crime will be taken under control, and the subway systems will be operating at normal capacity. But what about the lingering psychological effects a storm of this power can have?

PTSD (Post Traumatic Stress Disorder) incidents often flare up after a traumatic event like Hurricane Sandy, even for people living far from the affected area. South Florida is a prime area for PTSD reactions due to its frequent close encounters with hurricanes. PTSD symptoms often appear immediately but, in some cases, may take a while to manifest. No matter when they appear, though, PTSD symptoms have been known to linger for long periods of time, during which this disorder can have a dramatic effect on the daily lives of its victims.

Some PTSD stress symptoms that hurricane victims might experience include:

  • Trouble sleeping
  • An acute stress reaction, such as being easily startled or frightened
  • Trouble concentrating
  • Flashbacks to the hurricane
  • Feeling emotionally numb
  • Unsettling dreams related to the storm
  • Self-destructive behavior
  • Overwhelming guilt or shame
  • Angry outbursts
  • Memory problems
  • Avoidance behavior, such as keeping away from places, events, or objects that are reminders of the storm

If you or someone you know is experiencing PTSD symptoms like these it’s important to seek treatment as soon as possible because the sooner treatment begins the easier it is to keep the disorder under control and work toward relief. Delaying treatment of PTSD symptoms can mean that the PTSD can become so severe the victims could end up harming themselves or others.

Treatment for PTSD symptoms may include psychotherapy, cognitive behavioral therapy, and/or medication. Psychotherapy will allow victims the opportunity to discuss the hurricane and related events, while learning ways to manage their symptoms. Cognitive behavioral therapy will help people recognize and adjust trauma-related thoughts and beliefs in a more positive way. In some cases, medication may be used in combination with these other therapy techniques. Above all, therapy helps the person understand that a disorder like PTSD develops because of the extraordinary stress they have experienced, not because of their own weakness.

For more information on PTSD and for help and treatment of PTSD symptoms in the Boca Raton, Florida area, contact Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorder. You can reach us by calling 561-496-1094 or by emailing Dr. Rosen and The Center today.

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